Low sperm count diagnosis. Experiences?

stephers620

Hi everyone! New here! My husband and I are 33(he’s turning 34 in July) We got married in 2020 unfortunately and then we had to delay trying do do temporary job losses due to the pandemic so only started to try in 2021. Just got some absolutely horrible news regarding our fertility journey we have been trying since august. We hope this community will be kind and helpful in navigating this issue and be a source of hope and support.

We finally got tests done this month. Mine came back fine however my husband has a low Sperm count so I’m freaking out. I’m worried because he had already been taking vitamins to improve sperm quality when we were blissfully unaware there was a problem and figured they (sperm)are probably average and let’s just make them a bit better to increase our chances of conceiving quickly. Whelp even with that they are still low.His doctor is getting a retest done for him but feeling super frustrated. We followed instructions to a t …aka abstain for 48 hrs but don’t abstain for longer than 7 days we bd maybe 60 hours before. So now doctor wants to have him do 72hrs before and if not better has to see a urologist. I’m wondering how 72 hours could possibly make all the difference. Doctor failed to tell us the degree to which the count us low and mentioned nothing of motility live to dead ratio or shape. Feel like we are going through emotional torture as we have been waiting two days now for him to explain things as he literally just told us it was lower than 15 and if it doesn’t improve see specialist so my mind is running wild thinking about how bad it could be. To me if they are debating getting a specialist involved it must be pretty bad. Has anyone had any success conceiving naturally eventually with low sperm count and if so how bad was the sperm count? How long did it take?Looking for some light at the end of the tunnel we have just entered. I’m feeling mentally destroyed by this bad news we were already struggling with the time it was taking before this happened. Need some positivity! What options if any were suggested to you to get pregnant? Hoping there’s still hope to conceive without costly procedures we cannot afford but I’m new to this so looking for kind respectful responses that take into account this blow we just received to our dream of having our first child. In the past we’ve gotten very very rude responses in the ttc forum on here so please if you don’t have anything nice to say don’t say it at all. Thanks and please be respectful and kind

brooklyn7476

My husband has 0 sperm due to cancer treatments when he was in high school. However they cryopreserved a vial before the treatments as this is a known side effect, so we have a limited amount as well. Our doctors recommend IVF and ICSI, so they would retrieve your eggs through an IVF cycle and then introduce one sperm directly to the each egg to create embryos that can be transferred back to you. This sounds like it could be promising for you, as you would only need a dozen sperm. A fertility clinic can run the cost numbers for you and your specific insurance. Good luck!!

microlady

@stephers620 welcome to the forum! Sorry you have to be here with the rest of us and that people have been rude to you in the past 😔

Your post totally echoes how I felt at the beginning. Just some background on my journey..  my husband and I started seeing our REI for my PCOS, irregular cycles, and inability to conceive. We then found out after initial testing that my husband also has low sperm count (~700k) and low motility (25%) and was referred to a urologist. I felt a lot like you are describing. They went over the numbers so fast I could not comprehend how low we were and where we needed to be and what our chances were of conceiving. We tried clomid for him for three months with no budge in the numbers. He has a genetic component so this is probably why we saw no change.  So here’s what I can say to hopefully help you get some clarity:

1. It takes three months to see any effects on sperm production from medications/lifestyle changes due to how long it takes for the body to produce/mature new sperm.  Not sure how long your husband was taking supplements, but this could factor into it if they were going to help.  Let your doctor know what he was taking and maybe ask if they have ever seen improvements in patients taking that supplement.  Our doctor also wanted a second semen analysis about 1 month later to make sure the counts were still low and there wasn't a one time environmental factor that affected the first sample.  We did not see much difference between 2 or 4 days of abstaining.

2. Don’t be fearful of the urologist referral. This is pretty standard just to get everything checked out and try to find a cause. If you can find a urologist that specializes in fertility or is part of a fertility practice that was helpful for us. Our urologist was more realistic and explained our odds of conceiving and gave us the second opinion of IVF being our only option.  This approach may have been harsh for some, but for us it put everything into perspective and allowed us to make the decision to move forward with IVF.

3. Ask for the semen analysis report from your clinic. You need to know the count in thousands/millions (thousands, ten thousands, 100 thousands, millions, 10 millions, 100 millions etc.) to move forward with asking questions and understanding the answers.  I'm hoping for you that 15 means 15 million and maybe IUI is an option.  Sperm count and motility are what you really want to pay attention to as these numbers seem to dictate your treatment options.  Different treatment options may require a certain number of motile sperm.

4. Questions I wish I had asked to save myself from overthinking:

"x" = enter treatment option here (IUI, ovulation induction/timed intercourse, IVF, supplements/meds to improve counts, etc.)

What are our treatment options with the current counts? How likely are we to conceive with “x” treatment?

Where do the counts need to be for us to try “x” treatment?

If we try “x” treatment to improve the counts where can we hope to get the counts (#)? What improvements in motility can we hope to see? How high do we need the counts and motility for each treatment option?  What is the likelihood we achieve the counts and motility we need to try "x" treatment?

I will say if I had understood the answers to these questions, I probably would not have delayed moving to IVF for a year like we did to try to get the counts up because our counts were so low.  Write down your questions and make sure you get the answers you need in your appointment.  If your urologist is also part of a fertility practice, you may be able to get some of these answers from them as well.  Remember to take time for yourself to help process the information.  It is completely overwhelming at times and you may leave your appointments with more questions that answers.  Best advice I can give is to write those questions down for your next appointment.

If you have insurance, look closely at both of your insurance plans to see what is covered.  You will both need to be on the plan to get the most out of your coverage.  You fertility clinic most likely has a finance department who can help you figure out or understand your coverage.

Best of luck!  Stay positive!